<section article="gho" article_name="Health Occupations" number="15-101" title_number="15" title_name="Physician Assistants" subtitle_number="1" subtitle_name="Definitions; General Provisions"> <level label="a"> <text>In this title the following words have the meanings indicated.</text> </level> <level label="b"> <text>“Ambulatory surgical facility” means a facility:</text> <level label="1"> <text>Accredited by:</text> <level label="i"> <text>The American Association for Accreditation of Ambulatory Surgical Facilities;</text> </level> <level label="ii"> <text>The Accreditation Association for Ambulatory Health Care; or</text> </level> <level label="iii"> <text>The Joint Commission on Accreditation of Healthcare Organizations; or</text> </level> </level> <level label="2"> <text>Certified to participate in the Medicare program, as enacted by Title XVIII of the Social Security Act.</text> </level> </level> <level label="c"> <text>“Board” means the State Board of Physicians, established under § 14–201 of this article.</text> </level> <level label="d"> <level label="1"> <text>“Collaboration” means the communication and decision–making process among health care providers who are members of a patient care team related to the treatment of a patient that includes the degree of cooperation necessary to provide treatment and care to the patient and includes:</text> <level label="i"> <text>Communication of data and information about the treatment and care of a patient, including the exchange of clinical observations and assessments; and</text> </level> <level label="ii"> <text>Development of an appropriate plan of care, including:</text> <level label="1"> <text>Decisions regarding the health care provided;</text> </level> <level label="2"> <text>Accessing and assessment of appropriate additional resources or expertise; and</text> </level> <level label="3"> <text>Arrangement of appropriate referrals, testing, or studies.</text> </level> </level> </level> <level label="2"> <text>“Collaboration” does not require the constant, physical presence of a collaborating physician on–site in the practice setting, if the collaborating physician is accessible by electronic means.</text> </level> </level> <level label="e"> <text>“Collaboration agreement” means a document that:</text> <level label="1"> <text>Outlines the collaboration between a physician assistant and:</text> <level label="i"> <text>An individual physician; or</text> </level> <level label="ii"> <text>A group of physicians; and</text> </level> </level> <level label="2"> <text>Is developed by a physician assistant and the physician or group of physicians.</text> </level> </level> <level label="f"> <text>“Committee” means the Physician Assistant Advisory Committee.</text> </level> <level label="g"> <text>“Controlled dangerous substances” has the meaning stated in § 5–101 of the Criminal Law Article.</text> </level> <level label="h"> <text>“Correctional facility” includes a State or local correctional facility.</text> </level> <level label="i"> <text>“Disciplinary panel” means a disciplinary panel of the Board established under § 14–401 of this article.</text> </level> <level label="j"> <text>“Dispense” or “dispensing” has the meaning stated in § 12–101 of this article.</text> </level> <level label="k"> <text>“Drug sample” means a unit of a prescription drug that is intended to promote the sale of the drug and is not intended for sale.</text> </level> <level label="l"> <text>“Hospital” means:</text> <level label="1"> <text>A hospital as defined under § 19–301 of the Health – General Article;</text> </level> <level label="2"> <text>A comprehensive care facility that:</text> <level label="i"> <text>Meets the requirements of a hospital–based skilled nursing facility under federal law; and</text> </level> <level label="ii"> <text>Offers acute care in the same building; and</text> </level> </level> <level label="3"> <text>An emergency room that is physically connected to a hospital or a freestanding medical facility that is licensed under Title 19, Subtitle 3A of the Health – General Article.</text> </level> </level> <level label="m"> <text>“License” means a license issued by the Board to a physician assistant under this title.</text> </level> <level label="n"> <text>“National certifying examination” means the Physician Assistant National Certifying Examination administered by the National Commission on Certification of Physician Assistants or its successor.</text> </level> <level label="o"> <text>“Patient care team” means a multidisciplinary team of health care providers actively functioning as a unit with the leadership of one or more patient care team physicians for the purpose of providing and delivering health care to a patient or group of patients.</text> </level> <level label="p"> <text>“Patient care team physician” means a licensed physician who regularly practices in the State and who provides leadership in the care of patients as part of a patient care team.</text> </level> <level label="q"> <text>“Physician assistant” means an individual who is licensed under this title to practice as a physician assistant.</text> </level> <level label="r"> <text>“Practice as a physician assistant” means the performance of medical acts that are:</text> <level label="1"> <text>Authorized under a license issued by the Board; and</text> </level> <level label="2"> <text>Authorized under the physician assistant’s collaboration agreement.</text> </level> </level> <level label="s"> <text>“Prescriptive authority” means the authority of a physician assistant to:</text> <level label="1"> <text>Prescribe and administer controlled dangerous substances, prescription drugs, medical devices, and the oral, written, or electronic ordering of medications; and</text> </level> <level label="2"> <text>Dispense as provided under § 15–302.2(b), (c), and (d) of this title.</text> </level> </level> <level label="t"> <text>“Public health facility” means a site where clinical public health services are rendered under the auspices of the Department, a local health department in a county, or the Baltimore City Health Department.</text> </level> <level label="u"> <text>“Starter dosage” means an amount of a drug sufficient to begin therapy:</text> <level label="1"> <text>Of short duration of 72 hours or less; or</text> </level> <level label="2"> <text>Prior to obtaining a larger quantity of the drug to complete therapy.</text> </level> </level> </section> <section article="gho" article_name="Health Occupations" number="15-102" title_number="15" title_name="Physician Assistants" subtitle_number="1" subtitle_name="Definitions; General Provisions"> <level label="a"> <text>A physician assistant may not practice within the scope of practice of any of the following health occupations authorized under this article:</text> <level label="1"> <text>Nursing;</text> </level> <level label="2"> <text>Optometry;</text> </level> <level label="3"> <text>Physical therapy; or</text> </level> <level label="4"> <text>Psychology.</text> </level> </level> <level label="b"> <text>This title does not limit the right of an individual to practice a health occupation that the individual is authorized to practice under this article.</text> </level> </section> <section article="gho" article_name="Health Occupations" number="15-103" title_number="15" title_name="Physician Assistants" subtitle_number="1" subtitle_name="Definitions; General Provisions"> <level label="a"> <level label="1"> <text>Subject to paragraph (2) of this subsection, an employer of a physician assistant shall report to the Board, on the form prescribed by the Board, any termination of employment of the physician assistant if the cause of termination is related to a quality of care issue.</text> </level> <level label="2"> <text>Subject to subsection (c) of this section, a physician or group of physicians that develops a collaboration agreement with a physician assistant or an employer of a physician assistant shall notify the Board within 10 days of the termination of employment of the physician assistant for reasons that would be grounds for discipline under this title.</text> </level> <level label="3"> <text>A physician or group of physicians that develops a collaboration agreement with a physician assistant or the physician assistant shall immediately document the termination of the relationship in the collaboration agreement on file at the physician assistant’s primary place of business.</text> </level> </level> <level label="b"> <level label="1"> <text>Except as otherwise provided under subsections (c) and (e) of this section, each employer of a licensed physician assistant shall submit to the Board a report if:</text> <level label="i"> <text>The employer:</text> <level label="1"> <text>Reduced, suspended, revoked, restricted, denied, conditioned, or did not renew the licensed physician assistant’s clinical privileges, employment, or other ability to practice or treat patients;</text> </level> <level label="2"> <text>Involuntarily terminated or restricted the licensed physician assistant’s employment or staff membership; or</text> </level> <level label="3"> <text>Asked the licensed physician assistant to voluntarily resign because of the licensed physician assistant’s conduct or while the licensed physician assistant is being investigated; and</text> </level> </level> <level label="ii"> <text>The action described under item (i) of this paragraph was taken:</text> <level label="1"> <text>For reasons that might be grounds for disciplinary action under § 15–314 of this title;</text> </level> <level label="2"> <text>Because the licensed physician assistant may have engaged in an act that may constitute unprofessional conduct;</text> </level> <level label="3"> <text>Because the licensed physician assistant may be unable to practice as a physician assistant with reasonable skill and safety because of a physical or mental condition or professional incompetence; or</text> </level> <level label="4"> <text>Because the licensed physician assistant may have harmed or placed one or more patients or the public at unreasonable risk of harm by engaging in an act that creates an immediate or continuing danger.</text> </level> </level> </level> <level label="2"> <text>Each report submitted under paragraph (1) of this subsection shall include:</text> <level label="i"> <text>The action taken by the employer;</text> </level> <level label="ii"> <text>A detailed explanation of the reasons for the action, including references to specific patient medical records, if any, that informed the employer’s action; and</text> </level> <level label="iii"> <text>The steps taken by the employer to investigate the conduct of the licensed physician assistant.</text> </level> </level> <level label="3"> <level label="i"> <text>The Board may request from the employer additional information regarding an action described in paragraph (1) of this subsection that was taken by the employer.</text> </level> <level label="ii"> <text>If an employer receives a request made under subparagraph (i) of this paragraph, the employer shall promptly provide the additional information.</text> </level> </level> </level> <level label="c"> <text>If an employer knows that the conduct of a licensed physician assistant requires that the employer submit a report under subsection (b)(1) of this section because the physician assistant is impaired by alcohol or another substance, the employer is not required to report the licensed physician assistant to the Board if:</text> <level label="1"> <text>The employer knows that the licensed physician assistant is:</text> <level label="i"> <text>In a substance use disorder treatment program that is accredited by The Joint Commission or is certified by the Department; or</text> </level> <level label="ii"> <text>Under the care of a health care practitioner who is competent and capable of dealing with substance use disorders;</text> </level> </level> <level label="2"> <text>The employer is able to verify that the physician assistant remains in the treatment program until successful discharge; and</text> </level> <level label="3"> <text>The action or condition of the physician assistant has not caused injury to any person while the physician assistant is practicing as a licensed physician assistant.</text> </level> </level> <level label="d"> <text>If the employer knows that the licensed physician assistant is noncompliant with the substance use disorder treatment program, the employer of the licensed physician assistant shall report the licensed physician assistant’s noncompliance to the Board.</text> </level> <level label="e"> <level label="1"> <text>The Board may extend the reporting under this section for good cause shown.</text> </level> <level label="2"> <text>A person is not required under this section to make any report that would be in violation of any federal or State law, rule, or regulation concerning the confidentiality of substance use disorder patient records.</text> </level> </level> <level label="f"> <text>The Board may enforce this section by subpoena.</text> </level> <level label="g"> <text>Any person shall have the immunity from liability described under § 5–715(d) of the Courts Article for giving any of the information required by this section.</text> </level> <level label="h"> <text>An employer required to make a report to the Board under this section shall submit the report within 10 days after the action requiring the report.</text> </level> <level label="i"> <text>A report under this section is privileged, not subject to inspection under the Public Information Act, and not subject to subpoena or discovery in any civil action other than a proceeding arising out of a hearing and decision of the Board or a disciplinary panel under this title.</text> </level> <level label="j"> <level label="1"> <text>A disciplinary panel may impose a civil penalty of up to $5,000 for knowingly failing to report under this section.</text> </level> <level label="2"> <text>A disciplinary panel may impose a civil penalty of up to $5,000 per incident for a report made by an employer in bad faith.</text> </level> <level label="3"> <text>The Board shall pay any fees collected under this subsection into the General Fund of the State.</text> </level> </level> <level label="k"> <text>An employer shall make the report required under this section to the Board within 5 days after the date of termination of employment.</text> </level> <level label="l"> <text>The Board shall adopt regulations to implement the provisions of this section.</text> </level> </section> <section article="gho" article_name="Health Occupations" number="15-201" title_number="15" title_name="Physician Assistants" subtitle_number="2" subtitle_name="Physician Assistant Advisory Committee; Board; Commission"> <level label="a"> <text>There is a Physician Assistant Advisory Committee within the Board.</text> </level> <level label="b"> <text>The Committee shall function as a subunit of the Board.</text> </level> </section> <section article="gho" article_name="Health Occupations" number="15-202" title_number="15" title_name="Physician Assistants" subtitle_number="2" subtitle_name="Physician Assistant Advisory Committee; Board; Commission"> <level label="a"> <level label="1"> <text>The Committee shall consist of seven members appointed by the Board.</text> </level> <level label="2"> <text>Of the seven Committee members:</text> <level label="i"> <text>Three shall be licensed physicians;</text> </level> <level label="ii"> <text>Three shall be licensed physician assistants; and</text> </level> <level label="iii"> <text>One shall be a consumer.</text> </level> </level> <level label="3"> <text>Of the licensed physician members:</text> <level label="i"> <text>At least one shall specialize in general surgery or a surgical subspecialty; and</text> </level> <level label="ii"> <text>At least one shall specialize in internal medicine, family practice, or a similar primary care specialty.</text> </level> </level> <level label="4"> <text>The Board shall appoint the physician assistant members from a list of names submitted by:</text> <level label="i"> <text>The Maryland Academy of Physician Assistants; and</text> </level> <level label="ii"> <text>The State institutions of higher education with approved physician assistant programs.</text> </level> </level> <level label="5"> <text>Each member of the Committee licensed by the Board must be in good standing with the Board.</text> </level> <level label="6"> <text>The consumer member:</text> <level label="i"> <text>Must be a member of the general public;</text> </level> <level label="ii"> <text>May not be or have ever been:</text> <level label="1"> <text>A physician assistant;</text> </level> <level label="2"> <text>Any other health care professional; or</text> </level> <level label="3"> <text>In training to be a physician assistant or other health professional; and</text> </level> </level> <level label="iii"> <text>May not:</text> <level label="1"> <text>Participate or ever have participated in a commercial or professional field related to physician assistant practice;</text> </level> <level label="2"> <text>Have a household member who participates in a commercial or professional field related to physician assistant practice;</text> </level> <level label="3"> <text>Have had within 2 years before appointment a financial interest in a person regulated by the Board; or</text> </level> <level label="4"> <text>Have had within 2 years before appointment a financial interest in the provision of goods or services to physician assistants or to the field of physician assistant practice.</text> </level> </level> </level> <level label="7"> <text>Each member of the Committee must be a resident of the State.</text> </level> </level> <level label="b"> <text>Of the three physician members of the Committee, two shall be previously or currently serving as a patient care team physician under a collaboration agreement with a physician assistant.</text> </level> <level label="c"> <text>Of the three physician assistant members of the Committee:</text> <level label="1"> <text>At least one must be currently practicing in a hospital; and</text> </level> <level label="2"> <text>At least one must be currently practicing in a nonhospital setting.</text> </level> </level> <level label="d"> <level label="1"> <text>The term of a member is 3 years.</text> </level> <level label="2"> <text>The terms of members are staggered as required by regulation.</text> </level> <level label="3"> <text>At the end of a term, a member continues to serve until a successor is appointed and qualifies.</text> </level> <level label="4"> <text>A member who is appointed after a term has begun serves only for the rest of the term and until a successor is appointed and qualifies.</text> </level> <level label="5"> <text>A member may not serve more than two consecutive full terms.</text> </level> </level> <level label="e"> <text>From among its members, the Committee shall elect a chair every 2 years.</text> </level> <level label="f"> <text>The chair, or the chair’s designee, shall serve in an advisory capacity to the Board as a representative of the Committee.</text> </level> <level label="g"> <text>A quorum of the Committee consists of four members.</text> </level> </section> <section article="gho" article_name="Health Occupations" number="15-203" title_number="15" title_name="Physician Assistants" subtitle_number="2" subtitle_name="Physician Assistant Advisory Committee; Board; Commission"> <text>The Board shall adopt regulations governing:</text> <level label="1"> <text>The term of office for Committee members;</text> </level> <level label="2"> <text>The procedure for filling vacancies on the Committee;</text> </level> <level label="3"> <text>The removal of Committee members; and</text> </level> <level label="4"> <text>The duties of each officer.</text> </level> </section> <section article="gho" article_name="Health Occupations" number="15-204" title_number="15" title_name="Physician Assistants" subtitle_number="2" subtitle_name="Physician Assistant Advisory Committee; Board; Commission"> <text>Funds for compensation, expenses, and staff for the Committee shall be allocated to the Board in the State budget.</text> </section> <section article="gho" article_name="Health Occupations" number="15-205" title_number="15" title_name="Physician Assistants" subtitle_number="2" subtitle_name="Physician Assistant Advisory Committee; Board; Commission"> <text>In addition to the powers set forth elsewhere in this title, the Committee:</text> <level label="1"> <text>Shall:</text> <level label="i"> <text>Recommend to the Board:</text> <level label="1"> <text>Regulations for carrying out this title; and</text> </level> <level label="2"> <text>Any statutory changes that affect the profession;</text> </level> </level> <level label="ii"> <text>Recommend to the Board approval, modification, or disapproval of an application for licensure or the performance of advanced duties under a collaboration agreement;</text> </level> <level label="iii"> <text>Report to the Board any conduct of a physician or group of physicians who develops a collaboration agreement with a physician assistant or a physician assistant that may be cause for disciplinary action under this title or under § 14–404 of this article; and</text> </level> <level label="iv"> <text>Keep a record of its meetings; and</text> </level> </level> <level label="2"> <text>May:</text> <level label="i"> <text>Provide recommendations regarding the practice of physician assistants; and</text> </level> <level label="ii"> <text>Advise the Board on any other matters related to physician assistants.</text> </level> </level> </section> <section article="gho" article_name="Health Occupations" number="15-206" future_version_removed="true" title_number="15" title_name="Physician Assistants" subtitle_number="2" subtitle_name="Physician Assistant Advisory Committee; Board; Commission"> <level label="a"> <level label="1"> <text>The Board shall set reasonable fees for:</text> <level label="i"> <text>The issuance and renewal of licenses; and</text> </level> <level label="ii"> <text>The other services rendered by the Board in connection with physician assistants, including the cost of providing a rehabilitation program for physician assistants under § 14–401.1(g) of this article.</text> </level> </level> <level label="2"> <level label="i"> <text>In addition to the fee set by the Board under this title for the renewal of a license, the Board shall assess a separate $15 fee for a renewal of the license.</text> </level> <level label="ii"> <text>The Board shall pay the fee collected under subparagraph (i) of this paragraph to the Physician Assistant Preceptorship Tax Credit Fund established under § 10–752 of the Tax – General Article.</text> </level> </level> </level> <level label="b"> <text>Except as provided in subsection (a)(2)(ii) of this section, the Board shall pay all fees collected under this title to the Comptroller of the State.</text> </level> <level label="c"> <level label="1"> <text>In each fiscal year, if the Department does not implement a permanent funding structure under § 24–1702(b)(1) of the Health – General Article and the Governor does not include in the State budget at least $400,000 for the operation of the Maryland Loan Assistance Repayment Program for Physicians and Physician Assistants under Title 24, Subtitle 17 of the Health – General Article, as administered by the Department, the Comptroller shall distribute:</text> <level label="i"> <text>$400,000 of the fees received from the Board to the Department to be used to make grants under the Maryland Loan Assistance Repayment Program for Physicians and Physician Assistants under Title 24, Subtitle 17 of the Health – General Article to physicians and physician assistants engaged in primary care or to medical residents specializing in primary care who agree to practice for at least 2 years as primary care physicians in a geographic area of the State that has been designated by the Secretary as being medically underserved; and</text> </level> <level label="ii"> <text>The balance of the fees to the Board of Physicians Fund.</text> </level> </level> <level label="2"> <text>If the Governor includes in the State budget at least the amount specified in paragraph (1) of this subsection for the operation of the Maryland Loan Assistance Repayment Program for Physicians and Physician Assistants under Title 24, Subtitle 17 of the Health – General Article, as administered by the Department, the Comptroller shall distribute the fees to the Board of Physicians Fund.</text> </level> </level> </section> <section article="gho" article_name="Health Occupations" number="15-301" title_number="15" title_name="Physician Assistants" subtitle_number="3" subtitle_name="Certification"> <level label="a"> <text>This title may not be construed to authorize a physician assistant to practice independently.</text> </level> <level label="b"> <text>A license issued to a physician assistant shall limit the physician assistant’s scope of practice to medical acts:</text> <level label="1"> <text>Appropriate to the education, training, and experience of the physician assistant;</text> </level> <level label="2"> <text>Customary to the practice of a patient care team physician; and</text> </level> <level label="3"> <text>In a manner consistent with the collaboration agreement.</text> </level> </level> <level label="c"> <text>Patient services that may be provided by a physician assistant under a collaboration agreement include:</text> <level label="1"> <text>Obtaining comprehensive health histories;</text> </level> <level label="2"> <text>Performing physical examinations;</text> </level> <level label="3"> <text>Evaluating, diagnosing, managing, and providing medical treatment;</text> </level> <level label="4"> <text>Interpreting and evaluating patient data as authorized by a patient care team physician for the purpose of determining management and treatment of patients;</text> </level> <level label="5"> <text>Initiating requests for or performing diagnostic procedures as indicated by pertinent data and as authorized by a patient care team physician;</text> </level> <level label="6"> <text>Exercising prescriptive authority in accordance with § 15–302.2 of this subtitle;</text> </level> <level label="7"> <text>Informing patients about health promotion and disease prevention;</text> </level> <level label="8"> <text>Providing consultations;</text> </level> <level label="9"> <text>Writing medical orders;</text> </level> <level label="10"> <text>Obtaining informed consent;</text> </level> <level label="11"> <text>Delegating medical acts to licensed or unlicensed personnel as authorized under § 14–306 of this article if the physician assistant has at least 7,000 hours of clinical practice experience; and</text> </level> <level label="12"> <text>Certifying a patient’s health or disability as required by a federal, State, or local program.</text> </level> </level> <level label="d"> <level label="1"> <text>Except as otherwise provided in this title or §§ 10–14A–03 and 10–14B–03 of the State Government Article, an individual shall be licensed by the Board before the individual may practice as a physician assistant.</text> </level> <level label="2"> <text>Except as otherwise provided in this title, a physician may not collaborate with a physician assistant in the performance of medical acts without notifying the Board of a completed collaboration agreement with the Board.</text> </level> <level label="3"> <text>Except as otherwise provided in this title or in a medical emergency, a physician assistant may not perform any medical act:</text> <level label="i"> <text>For which the individual has not been licensed;</text> </level> <level label="ii"> <text>That has not been delegated in a manner consistent with the collaboration agreement;</text> </level> <level label="iii"> <text>That is not appropriate to the education, training, and experience of the physician assistant; and</text> </level> <level label="iv"> <text>That is not customary to the practice of a patient care team physician listed on the collaboration agreement.</text> </level> </level> </level> <level label="e"> <text>A physician assistant shall consult and collaborate with or refer an individual to an appropriate licensed physician or any other health care provider as appropriate.</text> </level> <level label="f"> <text>Except as otherwise provided in this title, the following individuals may practice as a physician assistant without a license:</text> <level label="1"> <text>A physician assistant student enrolled in a physician assistant educational program that is accredited by the Accreditation Review Commission on Education for the Physician Assistant or its successor and approved by the Board; or</text> </level> <level label="2"> <text>A physician assistant employed in the service of the federal government while practicing within the scope of the employment.</text> </level> </level> <level label="g"> <level label="1"> <text>If a medical act that is to be performed by a physician assistant under this section is a part of the practice of a health occupation that is regulated under this article by another board, any rule or regulation concerning that medical act shall be adopted jointly by the State Board of Physicians and the board that regulates the other health occupation.</text> </level> <level label="2"> <text>If the two boards cannot agree on a proposed rule or regulation, the proposal shall be submitted to the Secretary for a final decision.</text> </level> </level> </section> <section article="gho" article_name="Health Occupations" number="15-302" title_number="15" title_name="Physician Assistants" subtitle_number="3" subtitle_name="Certification"> <level label="a"> <text>A physician assistant may practice as a physician assistant only after providing notice to the Board, in a manner approved by the Board, of the executed collaboration agreement.</text> </level> <level label="b"> <level label="1"> <text>A collaboration agreement shall contain:</text> <level label="i"> <text>A description of the qualifications of the physician assistant and the physician or group of physicians who developed the collaboration agreement with the physician assistant;</text> </level> <level label="ii"> <text>Any practice specialty of the physician or group of physicians; and</text> </level> <level label="iii"> <text>A description of the settings in which the physician assistant will practice.</text> </level> </level> <level label="2"> <text>A collaboration agreement may include provisions limiting the physician assistant’s scope of practice, specifying office procedures, or otherwise detailing the practice of the physician assistant as agreed by the physician or group of physicians and the physician assistant.</text> </level> </level> <level label="c"> <text>If the Board determines that a patient care team physician or physician assistant is practicing in a manner inconsistent with the requirements of this title or Title 14 of this article, the Board on its own initiative or on the recommendation of the Committee may demand modification of the practice, withdraw the approval of an advanced duty regardless of whether the advanced duty requires prior approval under this section, or refer the matter to a disciplinary panel for the purpose of taking other disciplinary action under § 14–404 of this article or § 15–314 of this subtitle.</text> </level> <level label="d"> <level label="1"> <text>Except as provided under paragraph (2) of this subsection, a patient care team physician may not delegate medical acts under a collaboration agreement to more than eight physician assistants at any one time.</text> </level> <level label="2"> <text>A patient care team physician may delegate medical acts under a collaboration agreement to more than eight physician assistants in:</text> <level label="i"> <text>A hospital;</text> </level> <level label="ii"> <text>A correctional facility;</text> </level> <level label="iii"> <text>A detention center; or</text> </level> <level label="iv"> <text>A public health facility.</text> </level> </level> </level> <level label="e"> <text>A person may not coerce another person to enter into a collaboration agreement under this subtitle.</text> </level> <level label="f"> <text>Subject to the notice required under § 15–103 of this title, a physician assistant may terminate a collaboration agreement under this subtitle at any time.</text> </level> <level label="g"> <level label="1"> <text>In the event of a sudden departure, incapacity, or death of a patient care team physician, or change in license status that results in a patient care team physician being unable to legally practice medicine, the collaboration agreement will remain active and valid under the supervision of any remaining listed patient care team physicians.</text> </level> <level label="2"> <text>If there is no remaining patient care team physician listed on the collaboration agreement, the physician assistant may not practice until the physician assistant has executed a new collaboration agreement and, if applicable, has Board approval to perform any advanced duties delegated to the physician assistant under the new collaboration agreement.</text> </level> <level label="3"> <text>The Board may terminate a collaboration agreement if:</text> <level label="i"> <text>The physician assistant has a change in license status that results in the physician assistant being unable to legally practice as a physician assistant; or</text> </level> <level label="ii"> <text>Immediately after an event listed under paragraph (1) of this subsection if there is no remaining patient care team physician listed in the collaboration agreement.</text> </level> </level> </level> <level label="h"> <text>A physician assistant whose collaboration agreement is terminated may not practice as a physician assistant until the physician assistant executes a new collaboration agreement under this section.</text> </level> <level label="i"> <text>A physician assistant may practice in accordance with a collaboration agreement under this subtitle.</text> </level> <level label="j"> <text>A patient care team physician may be added or removed from a collaboration agreement by immediately documenting the addition or removal in the collaboration agreement on file at the physician assistant’s primary place of business.</text> </level> <level label="k"> <text>The Board may modify a collaboration agreement if it finds that:</text> <level label="1"> <text>The collaboration agreement does not meet the requirements of this subtitle; or</text> </level> <level label="2"> <text>The physician assistant is unable to perform the delegated duties safely.</text> </level> </level> <level label="l"> <text>A collaboration agreement shall be maintained at the practice setting and made available to the Board on request.</text> </level> <level label="m"> <text>A licensed physician assistant who fails to comply with the collaboration agreement requirements is subject to an administrative penalty as established in regulations.</text> </level> </section> <section article="gho" article_name="Health Occupations" number="15-302.1" title_number="15" title_name="Physician Assistants" subtitle_number="3" subtitle_name="Certification"> <level label="a"> <text>In this section, “exempt facility” means:</text> <level label="1"> <text>A hospital;</text> </level> <level label="2"> <text>An ambulatory surgical facility;</text> </level> <level label="3"> <text>A federally qualified health center; or</text> </level> <level label="4"> <text>Another practice setting listed on a hospital delineation of privileges document.</text> </level> </level> <level label="b"> <text>Except as provided in subsection (e) of this section, a physician assistant may perform advanced duties without Board approval if the advanced duty will be performed in an exempt facility and:</text> <level label="1"> <text>The physician assistant is supervised by a physician with credentials that have been reviewed by the exempt facility as a condition of employment as an independent contractor or as a member of the medical staff;</text> </level> <level label="2"> <text>The physician assistant has credentials that have been reviewed by the exempt facility as a condition of employment as an independent contractor or as a member of the medical staff; and</text> </level> <level label="3"> <text>The advanced duty to be delegated to the physician assistant is reviewed and approved in a process approved by the exempt facility before the physician assistant performs the advanced duty.</text> </level> </level> <level label="c"> <level label="1"> <text>Subject to paragraph (2) of this subsection and subsection (d) of this section and except as provided in subsection (e) of this section, a physician assistant may perform advanced duties in a practice setting that is not an exempt facility only after the physician assistant obtains Board approval of the advanced duty under the collaboration agreement.</text> </level> <level label="2"> <text>A physician assistant may perform X–ray duties in the medical office of a patient care team physician if:</text> <level label="i"> <text>The physician assistant has completed a course that includes radiographic studies of the extremities of at least 20 separate patients;</text> </level> <level label="ii"> <text>The X–rays are limited to the extremities;</text> </level> <level label="iii"> <text>The X–rays are performed under the direct supervision of a collaborating physician or radiologist;</text> </level> <level label="iv"> <text>The X–rays are performed using a mini C–arm or a similar low–level radiation machine to perform nonfluoroscopic X–ray procedures; and</text> </level> <level label="v"> <text>The physician assistant obtains Board approval of the X–ray duty as an advanced duty under the collaboration agreement.</text> </level> </level> </level> <level label="d"> <text>A physician assistant may not perform the medical acts of administering general anesthesia or neuroaxial anesthesia, including spinal, epidural, and image guided interventional spine procedures.</text> </level> <level label="e"> <text>A physician assistant may perform an advanced duty in collaboration with a patient care team physician without prior approval of the Board if:</text> <level label="1"> <text>The Board has previously approved the physician assistant to perform the advanced duty in collaboration with a patient care team physician; or</text> </level> <level label="2"> <text>The physician assistant has at least 7,000 hours of clinical practice experience.</text> </level> </level> <level label="f"> <text>If an advanced duty requires Board approval, the Committee:</text> <level label="1"> <text>Shall review the collaboration agreement;</text> </level> <level label="2"> <text>May conduct a personal interview of the physician assistant and patient care team physicians; and</text> </level> <level label="3"> <text>May recommend to the Board that the collaboration agreement be modified to ensure conformance with the requirements of this title.</text> </level> </level> <level label="g"> <level label="1"> <text>On review of the Committee’s recommendations regarding the request of a patient care team physician to delegate advanced duties as described in a collaboration agreement, the Board may modify the performance of advanced duties under a collaboration agreement if the physician assistant does not meet the applicable education, training, and experience requirements to perform the specified advanced duties.</text> </level> <level label="2"> <text>If the Board makes a modification under paragraph (1) of this subsection, the Board:</text> <level label="i"> <text>Shall notify the delegating patient care team physician listed in the collaboration agreement and the physician assistant in writing of the particular elements of the advanced duty approval request that were the cause for the modification; and</text> </level> <level label="ii"> <text>May not restrict the submission of an amendment to the advanced duty.</text> </level> </level> </level> <level label="h"> <text>Documentation demonstrating a physician assistant’s authority to perform an advanced duty under this section shall be maintained at the facility in which the physician assistant is performing the advanced duty.</text> </level> <level label="i"> <text>Individual members of the Board are not civilly liable for actions regarding the approval, modification, or disapproval of an advanced duty under the collaboration agreement described in this section.</text> </level> </section> <section article="gho" article_name="Health Occupations" number="15-302.2" title_number="15" title_name="Physician Assistants" subtitle_number="3" subtitle_name="Certification"> <level label="a"> <text>A patient care team physician may not delegate prescribing, dispensing, and administering of controlled dangerous substances, prescription drugs, or medical devices unless the patient care team physician and physician assistant include in the collaboration agreement:</text> <level label="1"> <text>The authority of the physician assistant to prescribe and, if applicable, dispense controlled dangerous substances, prescription drugs, or medical devices;</text> </level> <level label="2"> <text>An attestation that all prescribing and, if applicable, dispensing activities of the physician assistant will comply with applicable federal and State law and regulations;</text> </level> <level label="3"> <text>An attestation that all medical charts or records will contain a notation of any prescriptions written or dispensed by a physician assistant in accordance with this section;</text> </level> <level label="4"> <text>An attestation that all prescriptions dispensed under this section will include the physician assistant’s name and the patient care team physician’s name, business address, and business telephone number legibly written or printed;</text> </level> <level label="5"> <text>An attestation that all prescriptions written under this section will include the physician assistant’s name, business address, and business telephone number legibly written or printed;</text> </level> <level label="6"> <text>An attestation that the physician assistant has:</text> <level label="i"> <text>Passed the physician assistant national certification exam administered by the National Commission on the Certification of Physician Assistants within the previous 2 years; or</text> </level> <level label="ii"> <text>Successfully completed 8 category 1 hours of pharmacology education within the previous 2 years; and</text> </level> </level> <level label="7"> <text>An attestation that the physician assistant has:</text> <level label="i"> <text>A bachelor’s degree or its equivalent; or</text> </level> <level label="ii"> <text>Successfully completed 2 years of work experience as a physician assistant.</text> </level> </level> </level> <level label="b"> <level label="1"> <text>A patient care team physician may not delegate the prescribing or dispensing of substances that are identified as Schedule I controlled dangerous substances under § 5–402 of the Criminal Law Article.</text> </level> <level label="2"> <text>A patient care team physician may delegate the prescribing or dispensing of substances that are identified as Schedules II through V controlled dangerous substances under § 5–402 of the Criminal Law Article, including legend drugs as defined under § 503(b) of the Federal Food, Drug, and Cosmetic Act.</text> </level> <level label="3"> <text>A patient care team physician may not delegate the prescribing or dispensing of controlled dangerous substances to a physician assistant unless the physician assistant has a valid:</text> <level label="i"> <text>State controlled dangerous substance registration; and</text> </level> <level label="ii"> <text>Federal Drug Enforcement Agency (DEA) registration.</text> </level> </level> </level> <level label="c"> <level label="1"> <text>A patient care team physician may authorize a physician assistant to personally prepare and dispense a drug that the physician assistant is authorized to prescribe under a collaboration agreement if:</text> <level label="i"> <text>Except as otherwise provided under § 12–102(g) of this article, the patient care team physician possesses a dispensing permit; and</text> </level> <level label="ii"> <text>The physician assistant dispenses drugs only within:</text> <level label="1"> <text>The patient care team physician’s scope of practice; and</text> </level> <level label="2"> <text>The scope of the collaboration agreement.</text> </level> </level> </level> <level label="2"> <text>A patient care team physician may delegate any dispensing duties, including the performance of the final check of prescriptions as required under § 12–102(a)(4)(ii) of this article.</text> </level> </level> </section> <section article="gho" article_name="Health Occupations" number="15-303" title_number="15" title_name="Physician Assistants" subtitle_number="3" subtitle_name="Certification"> <level label="a"> <text>To qualify for a license, an applicant shall:</text> <level label="1"> <text>Complete a criminal history records check in accordance with § 14–308.1 of this article;</text> </level> <level label="2"> <text>Be of good moral character;</text> </level> <level label="3"> <text>Demonstrate oral and written competency in the English language as required by the Board;</text> </level> <level label="4"> <text>Be at least 18 years old;</text> </level> <level label="5"> <text>Except as provided in subsection (b) of this section, have successfully completed an educational program for physician assistants accredited by</text> <text>the Accreditation Review Commission on Education for the Physician Assistant or its predecessor; and</text> </level> <level label="6"> <text>Have passed the Physician Assistant National Certifying Examination administered by the National Commission on Certification of Physician Assistants.</text> </level> </level> <level label="b"> <text>An applicant who graduates from an accredited educational program for physician assistants under this section after October 1, 2003, shall have a bachelor’s degree or its equivalent.</text> </level> </section> <section article="gho" article_name="Health Occupations" number="15-304" title_number="15" title_name="Physician Assistants" subtitle_number="3" subtitle_name="Certification"> <text>An applicant for a license shall:</text> <level label="1"> <text>Complete a criminal history records check in accordance with § 14–308.1 of this article;</text> </level> <level label="2"> <text>Submit an application to the Board on the form that the Board requires; and</text> </level> <level label="3"> <text>Pay to the Board the application fee set by the Board.</text> </level> </section> <section article="gho" article_name="Health Occupations" number="15-305" title_number="15" title_name="Physician Assistants" subtitle_number="3" subtitle_name="Certification"> <level label="a"> <text>Subject to subsection (b) of this section, the Board shall issue a license to an applicant who meets the requirements of this title.</text> </level> <level label="b"> <level label="1"> <text>On receipt of the criminal history record information of an applicant for licensure forwarded to the Board in accordance with § 14–308.1 of this article, in determining whether to issue a license, the Board shall consider:</text> <level label="i"> <text>The age at which the crime was committed;</text> </level> <level label="ii"> <text>The nature of the crime;</text> </level> <level label="iii"> <text>The circumstances surrounding the crime;</text> </level> <level label="iv"> <text>The length of time that has passed since the crime;</text> </level> <level label="v"> <text>Subsequent work history;</text> </level> <level label="vi"> <text>Employment and character references; and</text> </level> <level label="vii"> <text>Other evidence that demonstrates whether the applicant poses a threat to the public health or safety.</text> </level> </level> <level label="2"> <text>The Board may not issue a license if the criminal history record information required under § 14–308.1 of this article has not been received.</text> </level> </level> </section> <section article="gho" article_name="Health Occupations" number="15-306" title_number="15" title_name="Physician Assistants" subtitle_number="3" subtitle_name="Certification"> <text>A license authorizes the licensee to practice as a physician assistant while the license is effective.</text> </section> <section article="gho" article_name="Health Occupations" number="15-307" title_number="15" title_name="Physician Assistants" subtitle_number="3" subtitle_name="Certification"> <level label="a"> <level label="1"> <text>Unless a license is renewed for an additional term as provided in this section, the license expires on the date set by the Board.</text> </level> <level label="2"> <text>The term of a license issued by the Board may not exceed 3 years.</text> </level> </level> <level label="b"> <text>At least 1 month before a license expires, the Board shall send to the licensee, by first–class mail to the last known address of the licensee, a renewal notice that states:</text> <level label="1"> <text>The date on which the current license expires;</text> </level> <level label="2"> <text>The date by which the Board must receive the renewal application for the renewal to be issued and mailed before the license expires; and</text> </level> <level label="3"> <text>The amount of the renewal fee.</text> </level> </level> <level label="c"> <text>Before a license expires, the licensee periodically may renew it for an additional 2–year term, if the licensee:</text> <level label="1"> <text>Is otherwise entitled to be issued a license;</text> </level> <level label="2"> <text>Pays to the Board the renewal fee, set by the Board;</text> </level> <level label="3"> <text>Submits to the Board:</text> <level label="i"> <text>A renewal application on the form that the Board requires; and</text> </level> <level label="ii"> <text>Satisfactory evidence of compliance with the continuing education requirements for license renewal set by the Board under this section; and</text> </level> </level> <level label="4"> <text>Meets any additional requirements set by the Board for renewal of a license.</text> </level> </level> <level label="d"> <text>In addition to any other qualifications and requirements established by the Board, the Board shall establish continuing education requirements as a condition for the renewal of licenses under this section.</text> </level> <level label="e"> <text>The Board shall renew the license of each licensee who meets the requirements of this section.</text> </level> <level label="f"> <text>For the failure of a licensee to obtain continuing medical education credits as required by the Board, a disciplinary panel may impose a civil penalty not to exceed $100 for each medical education credit not obtained by the licensee.</text> </level> <level label="g"> <level label="1"> <text>Beginning October 1, 2016, the Board shall require a criminal history records check in accordance with § 14–308.1 of this article for:</text> <level label="i"> <text>Renewal applicants as determined by regulations adopted by the Board; and</text> </level> <level label="ii"> <text>Each former licensee who files for reinstatement under this title.</text> </level> </level> <level label="2"> <text>On receipt of the criminal history record information of a licensee forwarded to the Board in accordance with § 14–308.1 of this article, in determining whether disciplinary action should be taken, based on the criminal history record information, against a licensee who renewed or reinstated a license, the Board shall consider:</text> <level label="i"> <text>The age at which the crime was committed;</text> </level> <level label="ii"> <text>The nature of the crime;</text> </level> <level label="iii"> <text>The circumstances surrounding the crime;</text> </level> <level label="iv"> <text>The length of time that has passed since the crime;</text> </level> <level label="v"> <text>Subsequent work history;</text> </level> <level label="vi"> <text>Employment and character references; and</text> </level> <level label="vii"> <text>Other evidence that demonstrates whether the licensee poses a threat to the public health or safety.</text> </level> </level> <level label="3"> <text>The Board may renew or reinstate a license only if the licensee or applicant attests that the licensee or applicant has submitted to a criminal history records check under § 14–308.1 of this article.</text> </level> </level> </section> <section article="gho" article_name="Health Occupations" number="15-308" title_number="15" title_name="Physician Assistants" subtitle_number="3" subtitle_name="Certification"> <level label="a"> <text>Subject to subsection (b) of this section, the Board, in accordance with its regulations, shall reinstate the license of a physician assistant who has failed to renew the license for any reason if the physician assistant:</text> <level label="1"> <text>Meets the renewal requirements of § 15–307 of this subtitle;</text> </level> <level label="2"> <text>Pays to the Board the reinstatement fee set by the Board;</text> </level> <level label="3"> <text>Submits to the Board satisfactory evidence of compliance with the qualifications and requirements established under this subtitle for license reinstatements; and</text> </level> <level label="4"> <text>Meets any additional requirements set by the Board for reinstatement.</text> </level> </level> <level label="b"> <text>A disciplinary panel may not reinstate a surrendered or revoked license that has been surrendered or revoked for a period of more than 1 year unless the licensee:</text> <level label="1"> <text>Meets the requirements for reinstatement as established under this title; and</text> </level> <level label="2"> <text>Completes a criminal history records check in accordance with § 14–308.1 of this article.</text> </level> </level> </section> <section article="gho" article_name="Health Occupations" number="15-309" title_number="15" title_name="Physician Assistants" subtitle_number="3" subtitle_name="Certification"> <level label="a"> <text>Each licensee shall keep a license and collaboration agreement for inspection at the primary place of business of the licensee.</text> </level> <level label="b"> <level label="1"> <text>A licensee shall provide the Board written notice of any change of name or address within 30 days after the change.</text> </level> <level label="2"> <text>A licensee who fails to comply with this subsection is subject to an administrative penalty of $100.</text> </level> </level> <level label="c"> <text>The Board may audit and review collaboration agreements kept by the licensee at the primary place of business of the licensee at any time.</text> </level> <level label="d"> <text>A physician assistant who fails to produce a collaboration agreement to the Board on request is subject to an administrative penalty as established in regulations.</text> </level> </section> <section article="gho" article_name="Health Occupations" number="15-310" title_number="15" title_name="Physician Assistants" subtitle_number="3" subtitle_name="Certification"> <level label="a"> <text>In reviewing an application for licensure or in investigating an allegation brought under § 15–314 of this subtitle, the Committee may request the Board to direct, or the Board on its own initiative may direct, the physician assistant to submit to an appropriate examination.</text> </level> <level label="b"> <text>In return for the privilege given to the physician assistant to practice as a physician assistant in the State, the physician assistant is deemed to have:</text> <level label="1"> <text>Consented to submit to an examination under this section, if requested by the Board in writing; and</text> </level> <level label="2"> <text>Waived any claim of privilege as to the testimony or examination reports.</text> </level> </level> <level label="c"> <text>The unreasonable failure or refusal of the licensed physician assistant or applicant to submit to an examination is prima facie evidence of the licensed physician assistant’s inability to practice as a physician assistant and is cause for denial of the application or immediate suspension of the license.</text> </level> <level label="d"> <text>The Board shall pay the costs of any examination made under this section.</text> </level> </section> <section article="gho" article_name="Health Occupations" number="15-311" title_number="15" title_name="Physician Assistants" subtitle_number="3" subtitle_name="Certification"> <text>Subject to the hearing provisions of § 15–315 of this subtitle, a disciplinary panel, on the affirmative vote of a majority of a quorum, may deny a license to any applicant for:</text> <level label="1"> <text>Any of the reasons that are grounds for disciplinary action under § 15–314 of this subtitle; and</text> </level> <level label="2"> <text>Failure to complete a criminal history records check in accordance with § 14–308.1 of this article.</text> </level> </section> <section article="gho" article_name="Health Occupations" number="15-312" title_number="15" title_name="Physician Assistants" subtitle_number="3" subtitle_name="Certification"> <level label="a"> <text>Unless a disciplinary panel agrees to accept the surrender of a license of a physician assistant, the physician assistant may not surrender the license nor may the licensure lapse by operation of law while the physician assistant is under investigation or while charges are pending.</text> </level> <level label="b"> <text>A disciplinary panel may set conditions on its agreement to accept surrender of a license.</text> </level> </section> <section article="gho" article_name="Health Occupations" number="15-314" title_number="15" title_name="Physician Assistants" subtitle_number="3" subtitle_name="Certification"> <level label="a"> <text>Subject to the hearing provisions of § 15–315 of this subtitle, a disciplinary panel, on the affirmative vote of a majority of the quorum, may reprimand any physician assistant, place any physician assistant on probation, or suspend or revoke a license if the physician assistant:</text> <level label="1"> <text>Fraudulently or deceptively obtains or attempts to obtain a license for the applicant or licensee or for another;</text> </level> <level label="2"> <text>Fraudulently or deceptively uses a license;</text> </level> <level label="3"> <text>Is guilty of:</text> <level label="i"> <text>Immoral conduct in the practice of medicine; or</text> </level> <level label="ii"> <text>Unprofessional conduct in the practice of medicine;</text> </level> </level> <level label="4"> <text>Is:</text> <level label="i"> <text>Professionally incompetent;</text> </level> <level label="ii"> <text>Physically incompetent; or</text> </level> <level label="iii"> <text>Mentally incompetent;</text> </level> </level> <level label="5"> <text>Solicits or advertises in violation of § 14–503 of this article;</text> </level> <level label="6"> <text>Abandons a patient;</text> </level> <level label="7"> <text>Habitually is intoxicated;</text> </level> <level label="8"> <text>Is addicted to, or habitually abuses, any narcotic or controlled dangerous substance as defined in § 5–101 of the Criminal Law Article;</text> </level> <level label="9"> <text>Provides professional services:</text> <level label="i"> <text>While under the influence of alcohol; or</text> </level> <level label="ii"> <text>While using any narcotic or controlled dangerous substance, as defined in § 5–101 of the Criminal Law Article, or other drug that is in excess of therapeutic amounts or without valid medical indication;</text> </level> </level> <level label="10"> <text>Promotes the sale of drugs, devices, appliances, or goods to a patient so as to exploit the patient for financial gain;</text> </level> <level label="11"> <text>Willfully makes or files a false report or record in the practice of medicine;</text> </level> <level label="12"> <text>Willfully fails to file or record any medical report as required under law, willfully impedes or obstructs the filing or recording of the report, or induces another to fail to file or record the report;</text> </level> <level label="13"> <text>On proper request, and in accordance with the provisions of Title 4, Subtitle 3 of the Health – General Article, fails to provide details of a patient’s medical record to the patient, another physician, or hospital;</text> </level> <level label="14"> <text>Solicits professional patronage through an agent or other person or profits from the acts of a person who is represented as an agent of the physician;</text> </level> <level label="15"> <text>Pays or agrees to pay any sum to any person for bringing or referring a patient or accepts or agrees to accept any sum from any person for bringing or referring a patient;</text> </level> <level label="16"> <text>Agrees with a clinical or bioanalytical laboratory to make payments to the laboratory for a test or test series for a patient, unless the licensed physician assistant discloses on the bill to the patient or third–party payor:</text> <level label="i"> <text>The name of the laboratory;</text> </level> <level label="ii"> <text>The amount paid to the laboratory for the test or test series; and</text> </level> <level label="iii"> <text>The amount of procurement or processing charge of the licensed physician, if any, for each specimen taken;</text> </level> </level> <level label="17"> <text>Makes a willful misrepresentation in treatment;</text> </level> <level label="18"> <text>Practices medicine with an unauthorized person or aids an unauthorized person in the practice of medicine;</text> </level> <level label="19"> <text>Establishes a pattern of excessive or medically unnecessary procedures or treatment;</text> </level> <level label="20"> <text>Offers, undertakes, or agrees to cure or treat disease by a secret method, treatment, or medicine;</text> </level> <level label="21"> <text>Is disciplined by a licensing or disciplinary authority or convicted or disciplined by a court of any state or country, or disciplined by any branch of the uniformed services or the U.S. Department of Veterans Affairs, for an act that would be grounds for disciplinary action under the Board’s disciplinary statutes;</text> </level> <level label="22"> <text>Fails to meet appropriate standards for the delivery of quality medical and surgical care performed in an outpatient surgical facility, office, hospital, or any other location in this State;</text> </level> <level label="23"> <text>Willfully submits false statements to collect fees for which services are not provided;</text> </level> <level label="24"> <text>Was subject to investigation or disciplinary action by a licensing or disciplinary authority or by a court of any state or country for an act that would be grounds for disciplinary action under this section and the licensee:</text> <level label="i"> <text>Surrendered the license issued by the state or country to the state or country; or</text> </level> <level label="ii"> <text>Allowed the license issued by the state or country to expire or lapse;</text> </level> </level> <level label="25"> <text>Willfully fails to report suspected child abuse in violation of § 5–704 of the Family Law Article;</text> </level> <level label="26"> <text>Fails to educate a patient being treated for breast cancer of alternative methods of treatment as required by § 20–113 of the Health – General Article;</text> </level> <level label="27"> <text>Sells, prescribes, gives away, or administers drugs for illegal or illegitimate medical purposes;</text> </level> <level label="28"> <text>Fails to comply with the provisions of § 12–102 of this article;</text> </level> <level label="29"> <text>Refuses, withholds from, denies, or discriminates against an individual with regard to the provision of professional services for which the physician assistant is licensed and qualified to render because the individual is HIV positive;</text> </level> <level label="30"> <text>Except as to an association that has remained in continuous existence since July 1, 1963:</text> <level label="i"> <text>Associates with a pharmacist as a partner or co–owner of a pharmacy for the purpose of operating a pharmacy;</text> </level> <level label="ii"> <text>Employs a pharmacist for the purpose of operating a pharmacy; or</text> </level> <level label="iii"> <text>Contracts with a pharmacist for the purpose of operating a pharmacy;</text> </level> </level> <level label="31"> <text>Except in an emergency life–threatening situation where it is not feasible or practicable, fails to comply with the Centers for Disease Control and Prevention’s guidelines on universal precautions;</text> </level> <level label="32"> <text>Fails to display the notice required under § 14–415 of this article;</text> </level> <level label="33"> <text>Fails to cooperate with a lawful investigation conducted by the Board or a disciplinary panel;</text> </level> <level label="34"> <text>Is convicted of insurance fraud as defined in § 27–801 of the Insurance Article;</text> </level> <level label="35"> <text>Is in breach of a service obligation resulting from the applicant’s or licensee’s receipt of State or federal funding for the physician assistant’s medical education;</text> </level> <level label="36"> <text>Willfully makes a false representation when seeking or making application for licensure or any other application related to the practice of medicine;</text> </level> <level label="37"> <text>Intimidates or influences, or attempts to intimidate or influence, for the purpose of causing any person to withhold or change testimony in hearings or proceedings before the Board or a disciplinary panel or those otherwise delegated to the Office of Administrative Hearings;</text> </level> <level label="38"> <text>Willfully hinders, prevents, or otherwise delays any person from making information available to the Board or a disciplinary panel in furtherance of any investigation of the Board or a disciplinary panel;</text> </level> <level label="39"> <text>Intentionally misrepresents credentials for the purpose of testifying or rendering an expert opinion in hearings or proceedings before the Board or a disciplinary panel or those otherwise delegated to the Office of Administrative Hearings;</text> </level> <level label="40"> <text>Fails to keep adequate medical records;</text> </level> <level label="41"> <text>Performs medical acts in a manner that is not consistent with the collaboration agreement;</text> </level> <level label="42"> <text>Performs medical acts which are outside the education, training, and experience of the physician assistant;</text> </level> <level label="43"> <text>Performs medical acts that are not customary to the practice of the patient care team physicians listed on the collaboration agreement;</text> </level> <level label="44"> <text>Practices as a physician assistant without first providing notice to the Board as required under § 15–302(a) of this subtitle;</text> </level> <level label="45"> <text>Fails to complete a criminal history records check under § 14–308.1 of this article;</text> </level> <level label="46"> <text>Fails to comply with the requirements of the Prescription Drug Monitoring Program under Title 21, Subtitle 2A of the Health – General Article;</text> </level> <level label="47"> <text>Fails to comply with any State or federal law pertaining to the practice as a physician assistant; or</text> </level> <level label="48"> <text>Willfully makes a misrepresentation to a disciplinary panel.</text> </level> </level> <level label="b"> <level label="1"> <text>On the filing of certified docket entries with the Board by the Office of the Attorney General, a disciplinary panel shall order the suspension of a license if the physician assistant is convicted of or pleads guilty or nolo contendere with respect to a crime involving moral turpitude, whether or not any appeal or other proceeding is pending to have the conviction or plea set aside.</text> </level> <level label="2"> <text>After completion of the appellate process if the conviction has not been reversed or the plea has not been set aside with respect to a crime involving moral turpitude, a disciplinary panel shall order the revocation of a license on the certification by the Office of the Attorney General.</text> </level> </level> </section> <section article="gho" article_name="Health Occupations" number="15-315" title_number="15" title_name="Physician Assistants" subtitle_number="3" subtitle_name="Certification"> <level label="a"> <level label="1"> <text>Except as otherwise provided under § 10–226 of the State Government Article, before a disciplinary panel takes any action under § 15–311 or § 15–314(a) of this subtitle, the disciplinary panel shall give the individual against whom the action is contemplated an opportunity for a hearing before a hearing officer.</text> </level> <level label="2"> <text>The hearing officer shall give notice and hold the hearing in accordance with Title 10, Subtitle 2 of the State Government Article.</text> </level> <level label="3"> <text>A disciplinary panel may administer oaths in connection with any proceeding under this section.</text> </level> </level> <level label="b"> <level label="1"> <text>Any licensee who is aggrieved by a final decision of the Board or a disciplinary panel under this subtitle may take a direct judicial appeal.</text> </level> <level label="2"> <text>The appeal shall be as provided for judicial review of the final decision in Title 10, Subtitle 2 of the State Government Article.</text> </level> </level> <level label="c"> <text>An order of the Board or a disciplinary panel under this subtitle may not be stayed pending review.</text> </level> <level label="d"> <text>All of the findings and orders of the Board or a disciplinary panel that relate to physician assistants are subject to the provisions of Title 14, Subtitle 4 of this article.</text> </level> </section> <section article="gho" article_name="Health Occupations" number="15-316" title_number="15" title_name="Physician Assistants" subtitle_number="3" subtitle_name="Certification"> <level label="a"> <text>If, after a hearing under § 15–315 of this subtitle, a disciplinary panel finds that there are grounds for discipline under § 15–314(a) of this subtitle to suspend or revoke a license of a physician assistant, reprimand a licensed physician assistant, or place the licensed physician assistant on probation, the disciplinary panel may impose a fine subject to the Board’s regulations in addition to suspending or revoking the license, reprimanding the licensee, or placing the licensee on probation.</text> </level> <level label="b"> <text>The Board shall pay any fines collected under this section into the General Fund of the State.</text> </level> <level label="c"> <text>In addition to any sanction authorized under this subtitle, a disciplinary panel may require a licensee to comply with specified terms and conditions determined by the disciplinary panel.</text> </level> </section> <section article="gho" article_name="Health Occupations" number="15-316.1" title_number="15" title_name="Physician Assistants" subtitle_number="3" subtitle_name="Certification"> <level label="a"> <text>Following the filing of charges or notice of initial denial of license application, the Board shall disclose the filing to the public on the Board’s Web site.</text> </level> <level label="b"> <text>The Board shall create and maintain a public individual profile on each licensee that includes the following information:</text> <level label="1"> <text>A summary of charges filed against the licensee, including a copy of the charging document, until a disciplinary panel has taken action under § 15–314 of this subtitle based on the charges or has rescinded the charges;</text> </level> <level label="2"> <text>A description of any disciplinary action taken by the Board or a disciplinary panel against the licensee within the most recent 10–year period that includes a copy of the public order;</text> </level> <level label="3"> <text>A description in summary form of any final disciplinary action taken by a licensing board in any other state or jurisdiction against the licensee within the most recent 10–year period;</text> </level> <level label="4"> <text>A description of a conviction or entry of a plea of guilty or nolo contendere by the licensee for a crime involving moral turpitude that is the basis for disciplinary action taken under § 15–314(b) of this subtitle; and</text> </level> <level label="5"> <text>The public address of the licensee.</text> </level> </level> <level label="c"> <text>In addition to the requirements of subsection (b) of this section, the Board shall include on each licensee’s profile a statement of information to be taken into consideration by a consumer when viewing a licensee’s profile, including a disclaimer stating that a charging document does not indicate a final finding of guilt by a disciplinary panel.</text> </level> <level label="d"> <text>The Board:</text> <level label="1"> <text>On receipt of a written request for a licensee’s profile from any person, shall forward a written copy of the profile to the person; and</text> </level> <level label="2"> <text>Shall maintain a Web site that serves as a single point of entry where all licensee profile information is available to the public on the Internet.</text> </level> </level> <level label="e"> <text>The Board shall provide a mechanism for the notification and prompt correction of any factual inaccuracies in a licensee’s profile.</text> </level> <level label="f"> <text>The Board shall include information relating to charges filed against a licensee by a disciplinary panel and any final disciplinary action taken by a disciplinary panel against a licensee in the licensee’s profile within 10 days after the charges are filed or the action becomes final.</text> </level> </section> <section article="gho" article_name="Health Occupations" number="15-317" title_number="15" title_name="Physician Assistants" subtitle_number="3" subtitle_name="Certification"> <level label="a"> <text>A physician assistant who is licensed in this State or in any other state or who is an employee of the federal government is authorized to perform acts, tasks, or functions as a physician assistant during a disaster as defined by the Governor, within a county in which a state of disaster has been declared, or counties contiguous to a county in which a state of disaster has been declared.</text> </level> <level label="b"> <text>The physician assistant shall notify the Board in writing of the names, practice locations, and telephone numbers for the physician assistant within 30 days after the first performance of medical acts, tasks, or functions as a physician assistant during the disaster.</text> </level> <level label="c"> <text>A team of physicians and physician assistants or physician assistants practicing under this section may not be required to maintain on–site documentation describing collaboration agreements as otherwise required under this title.</text> </level> </section> <section article="gho" article_name="Health Occupations" number="15-401" title_number="15" title_name="Physician Assistants" subtitle_number="4" subtitle_name="Prohibited Acts; Penalties"> <text>Except as otherwise provided in this title, a person may not practice, attempt to practice, or offer to practice as a physician assistant in the State unless the person has:</text> <level label="1"> <text>A license issued by the Board to practice as a physician assistant; and</text> </level> <level label="2"> <text>Provided notice to the Board as required under § 15–302(a) of this subtitle.</text> </level> </section> <section article="gho" article_name="Health Occupations" number="15-402" title_number="15" title_name="Physician Assistants" subtitle_number="4" subtitle_name="Prohibited Acts; Penalties"> <level label="a"> <text>Except as otherwise provided under this title, a person may not represent or imply to the public by use of the title “licensed physician assistant”, by other title, or by description of services, methods, or procedures that the person is licensed to practice as a physician assistant in the State.</text> </level> <level label="b"> <text>Unless licensed to practice as a physician assistant under this title, a person may not use the words or terms “physician assistant”, “licensed physician assistant”, or “P.A.”.</text> </level> </section> <section article="gho" article_name="Health Occupations" number="15-402.1" title_number="15" title_name="Physician Assistants" subtitle_number="4" subtitle_name="Prohibited Acts; Penalties"> <level label="a"> <text>Except as otherwise provided in this subtitle, a licensed physician may not employ an individual practicing as a physician assistant who does not have a license or who has not provided notice to the Board as required under § 15–302(a) of this title.</text> </level> <level label="b"> <text>Except as otherwise provided in this subtitle, an employer may not employ an individual practicing as a physician assistant who does not have a license.</text> </level> <level label="c"> <text>A disciplinary panel may impose a civil penalty in an amount not exceeding $5,000 for a violation of this section.</text> </level> <level label="d"> <text>The Board shall remit any penalty collected under this section into the Board of Physicians Fund.</text> </level> </section> <section article="gho" article_name="Health Occupations" number="15-403" title_number="15" title_name="Physician Assistants" subtitle_number="4" subtitle_name="Prohibited Acts; Penalties"> <level label="a"> <text>A person who violates § 15–401 or § 15–402 of this subtitle:</text> <level label="1"> <text>Is guilty of a misdemeanor and on conviction is subject to a fine not exceeding $5,000 or imprisonment not exceeding 5 years or both; and</text> </level> <level label="2"> <text>Shall lose licensure as a physician assistant under this title.</text> </level> </level> <level label="b"> <level label="1"> <text>In addition to the penalties under subsection (a) of this section, a person who violates § 15–401 of this subtitle may be subject to a civil penalty assessed by a disciplinary panel in an amount not exceeding $5,000.</text> </level> <level label="2"> <text>In addition to the penalties under paragraph (1) of this subsection, a person who violates § 15–309 of this title may be subject to a civil penalty assessed by a disciplinary panel in an amount not exceeding $100.</text> </level> <level label="3"> <text>The Board shall pay any civil penalty collected under this subsection into the Board of Physicians Fund.</text> </level> </level> </section> <section article="gho" article_name="Health Occupations" number="15-501" title_number="15" title_name="Physician Assistants" subtitle_number="5" subtitle_name="Short Title; Termination of Title"> <text>This title may be cited as the “Maryland Physician Assistants Act”.</text> </section> <section article="gho" article_name="Health Occupations" number="15-502" title_number="15" title_name="Physician Assistants" subtitle_number="5" subtitle_name="Short Title; Termination of Title"> <text>Subject to the evaluation and reestablishment provisions of the Maryland Program Evaluation Act, this title and all regulations adopted under this title shall terminate and be of no effect after July 1, 2030.</text> </section>